Patrick Hofmann1, Malcolm Kohler1,2, Christian Benden1,2, Macé M Schuurmans2,3. 1. Division of Pulmonology, University Hospital Zurich, Zurich, Switzerland. 2. University of Zurich, Zurich, Switzerland. 3. Division of Pulmonology, Cantonal Hospital Winterthur, Zurich, Switzerland.
Abstract
BACKGROUND: Smoking remains the leading cause of preventable disease and death in the developed world that kills half of all long-term users. Tobacco use after solid organ transplantation is associated with allograft dysfunction, cancer, and reduced overall survival. METHODS: In this single-center, retrospective study, we describe the frequency of tobacco use after lung transplantation (LTx), pretransplant patient characteristics associated with tobacco use, and the safety, efficacy, and outcomes of posttransplant tobacco cessation interventions. RESULTS: Four percent of our LTx cohort resumed tobacco use posttransplant. Chronic obstructive pulmonary disease (P = 0.043), the cessation duration before LTx (P < 0.001), and the packyear-cessation index (PCI) (P < 0.001) were found to be significantly associated with tobacco use posttransplant. A PCI cutoff value of 0.32 had 100% sensitivity and 45% specificity for tobacco use resumption. Thirty-five percent of the posttransplant tobacco users successfully quit tobacco consumption. CONCLUSIONS: Patients with chronic obstructive pulmonary disease and a short duration of smoking cessation before LTx were at greatest risk of tobacco use after LTx. The PCI may be a useful predictor of tobacco use resumption. Pharmacological tobacco cessation interventions were found to have a comparable safety and efficacy profile compared to nontransplant patients.
BACKGROUND: Smoking remains the leading cause of preventable disease and death in the developed world that kills half of all long-term users. Tobacco use after solid organ transplantation is associated with allograft dysfunction, cancer, and reduced overall survival. METHODS: In this single-center, retrospective study, we describe the frequency of tobacco use after lung transplantation (LTx), pretransplant patient characteristics associated with tobacco use, and the safety, efficacy, and outcomes of posttransplant tobacco cessation interventions. RESULTS: Four percent of our LTx cohort resumed tobacco use posttransplant. Chronic obstructive pulmonary disease (P = 0.043), the cessation duration before LTx (P < 0.001), and the packyear-cessation index (PCI) (P < 0.001) were found to be significantly associated with tobacco use posttransplant. A PCI cutoff value of 0.32 had 100% sensitivity and 45% specificity for tobacco use resumption. Thirty-five percent of the posttransplant tobacco users successfully quit tobacco consumption. CONCLUSIONS:Patients with chronic obstructive pulmonary disease and a short duration of smoking cessation before LTx were at greatest risk of tobacco use after LTx. The PCI may be a useful predictor of tobacco use resumption. Pharmacological tobacco cessation interventions were found to have a comparable safety and efficacy profile compared to nontransplant patients.
Authors: Tobias Veit; Dieter Munker; Gabriela Leuschner; Carlo Mümmler; Alma Sisic; Teresa Kauke; Christian Schneider; Michael Irlbeck; Sebastian Michel; Daniela Eser-Valerie; Maximilian Huber; Jürgen Barton; Katrin Milger; Bruno Meiser; Jürgen Behr; Nikolaus Kneidinger Journal: PLoS One Date: 2020-06-18 Impact factor: 3.240